Page 24 - Problem-Based Feline Medicine

16 PART 1 CAT WITH UPPER RESPIRATORY TRACT SIGNS

See main reference on page 28 for details (The Cat Upper respiratory tract signs are most common, and
With Chronic Nasal Disease). include sneezing, snuffling and chronic nasal dis-
charge.
Grass or seeds may occasionally enter the nose of
Nasal discharge may be unilateral or bilateral, and
cats. Other foreign bodies such as gun pellets are less
serous, mucopurulent or hemorrhagic.
common.
Distortion and swelling over the bridge of nose, or a
polyp-like mass projecting from the nasal cavity are
Clinical signs
present in 70% of cats with the respiratory form.
Typically there is an acute onset of sneezing and dis-
Depression, anorexia or inappetence and weight loss are
tress, and rubbing at the face.
often present with nasal or CNS involvement.
Signs may progress to chronic gagging, or sneezing and
Submandibular lymph nodes are often enlarged.
discharge.
A unilateral serosanguinous discharge is typically Diagnosis
present.
Diagnosis is based on cytological identification of the
organism in nasal discharge, exudate from skin lesions,
lymph node aspirate, cerebrospinal fluid (CSF), or ocu-
Diagnosis
lar aspirate. Cryptococcus appears as yeast-like organ-
Visualize foreign body using an otoscope, fiberoptic isms (5–15 μm) surrounded by a wide, clear capsule.
scope, or with a dental mirror in the nasopharynx. Use
Serology to detect cryptococcal capsular antigen in
a spay hook to retract the soft palate for better visuali-
blood, CSF, or urine is sensitive and specific.
zation.
Tissue biopsy of the granulomatous mass or skin lesion,
Flushing the nose using a naso-esophageal feeding
and histological identification of the organism may be
catheter may remove parts or all of the whole foreign
required if cytology is negative.
body for diagnosis.
Fungal isolation with culture is rarely required for
diagnosis, but is useful for sensitivity testing.
CRYPTOCOCCOSIS
BLEEDING ULCER ON EXTERNAL NARES
Classical signs
Classical signs
● Chronic nasal discharge and sneezing,
progressing in severity. ● Bleeding ulcer on external nares.
● Soft tissue swelling over the nasal bones ● ± Sneezing.
(Roman nose), or polyp-like mass in nasal
cavity. See main reference on page 27 for details (The Cat
● Facial distortion. With Signs of Chronic Nasal Disease).

See main reference on page 25 for details (The Cat With Clinical signs
Signs of Chronic Nasal Disease).
Acute sneezing and/or discharge may occasionally
occur associated with a bleeding ulcer on the external
nares, particularly the nasal septum. It is usually asso-
Clinical signs
ciated with squamous cell carcinoma (SCC), but
Occasionally, the initial signs of cryptococcosis are occasionally with eosinophilic granuloma or with
acute in onset. acute calicivirus infection.